Effect of Adjuvant Mitomycin C on Severe Traumatic Retinal Detachments Managed With Relaxing Retinotomy and Retinectomy

Purpose: To investigate the effect of adjuvant mitomycin C (MMC) on severe traumatic retinal detachments (RDs) with advanced proliferative vitreoretinopathy secondary to open-globe injury, managed with relaxing retinotomy and retinectomy. Methods: Medical records of 43 consecutive patients with traumatic RD undergoing relaxing retinotomy and retinectomy between 2016 and 2022 were retrospectively analyzed. Patients were categorized into those who received 20 µg/mL MMC via the MMC sandwich method (group 1) and those who did not (group 2). Preoperative characteristics, surgical interventions, and postoperative outcomes were compared. Results: Group differences in baseline variables were not statistically significant, except for the time interval between trauma and vitrectomy ( P = .018). The mean (±SD) follow-up time was 29.6 ± 10 months. The preoperative best-corrected visual acuity (BCVA) was a median 3.00 logMAR (interquartile range [IQR], 1.00–4.00) in group 1 and 3.50 logMAR (IQR, 1.30–4.00) in group 2. Postoperatively, the median BCVA was 1.85 logMAR (IQR, 0.00–3.00) in group 1 and 3.00 logMAR (IQR, 0.50–4.00) in group 2 ( P < .001). The final sustained retinal attachment rate was 95% in group 1 and 68% in group 2 ( P = .022). The postoperative intraocular pressure was a median 14 mm Hg (IQR, 8–18) in group 1 and 14 mm Hg (IQR, 4–17) in group 2 ( P = .220). There was no MMC-related toxicity observed. Conclusions: MMC can be safely used with the MMC sandwich technique for severe traumatic RDs managed by relaxing retinotomy and retinectomy, with favorable anatomic and functional outcomes despite the small sample size.